tv NBC Bay Area News Special NBC October 12, 2013 6:30pm-7:01pm PDT
under the act. >> millions can get access to affordable health care they didn't get before. >> we'll show you how to crunch the numbers so you'll figure out what you will pay. >> through the covered california people will get what they can afford. >> and what preventable services are covered for free. >> to not have to worry about going to bankrupt and get access to high quality care, that's life saving. >> here is jessica agearry, raj mathai and janel wang. >> we eve heard the hype open the criticism and enrollment has begun. beginning january 1st, just about everyone will be required to have health insurance. >> feeling overwhemed, adopt worry. for the next 30 minutes we're going to walk you through the
act explaining who it means. we will go through all of the insurance options and talk money, specifically we'll show you how to figure out what you'll likely pay and who is eligible for tax credit. we'll also show you what services will be covered. so let's get started. >> all right. it is estimated that 7 million californians don't have health insurance so it shouldn't come as a big surprise that many people are flocking to covered california to check out their options. we begin with sam brock who shows us exactly who's eligible to buy health on covered california. >> californians with health insurance, without health insurance and trying to find quality health insurance covered california offers a little something for everybody. >> the only qualify dagss for purchasing on the exchange is that you are a legal resident
and that you are not incarcer e incarcerat incarcerated. dana howard helped us trace out who's likely to join and in what numbers. it will take a few years but projections show 1.4 new million med cal applicants. then there's another 5.3 million people without health insurance. half of those will be eligible for subsidies. the subsidies are going to make a big difference. >> if you're eligible for subsidies and you're at the lower end of the income scale, they are incredibly meaningful and could really deliver something for you that is very affordable. >> insurance experts will tell you without subsidies the health exchange options will net you much lower savings if any. here's what you need to keep in mind. plans on the exchange will bring you richer benefits due to new
federal standards and anybody can opt out and buy a product on the exchange. >> you can make that switch. i mean you can drop coverage from your employer and go buy coverage in the exchange or outside of the exchange if you think it's a better deal for you. my caution is that's going to be difficult if you don't qualify for subsidies because you will be leaving the employer's contribution on the table. >> so we know who's eligible, let's talk about the options available. there are a lot of options, which insurance company and what type op plan. sam brock continues our coverage. >> folks who purchase health insurance on the online exchange will have to wait until january to reap the benefits but enrollment has already opened its doors. >> people need to understand that they only can buy coverage in california between october and march of next year for 2014. otherwise they won't be able to purr kmas coverage until 2015. >> charles barkley's trade group
represents all insurance companies in california, including the 12 with certified plans on covered california. now for the whole state of california there are 12 insurance companies offering health care plans on the exchange. you can see them in the list on the right hand side of the page. in fact that number tends to virry quite a bit in the regions. there are 19 regions in the state of california. in san francisco there are five different companies offering plans. they range from hmos to ppos. in alameda county there are four different insurance companies with plans and in the sant cruz monterey region there are three companies. so where you live will determine how many companies you can choose from but typically it's going to be between three and five different companies. once you narrow down a plan, it's important to remember that you still have plenty of choices. now each plan comes with an option of four different tiers,
platinum, gold, silver and bronze. now keep in mind the only difference for all of these is how much you're paying up front in premiums versus house you'll pay later in copays and medical bills. that's it. the platinum plan will cover 90% of your medical bills but in turn you'll pay more in premiums. on the other hand at the other end of the spectrum, the bronze plan covers about 60% of your bills. but for those who aren't worried about bills on don't think they're going to get sick, the premiums will be lower. >> all of the benefits are the same depending on which level you're at, bronze, silver, gold or platinum. and that allows customers to make what we call an apples to apples comparison. no long are they trying to figure out what benefits am i getting. now aonly what have to figure out what's it going to cost and if my hospital and doctor is within that plan.
>> covered california has an interactive website to help you out. on the home page there are five tabs that link you to insurance information and resources we have about us, coverage, resources and there's a new center tab and languages where you can pick from 13 languages. then towards the bottom of the screen there's an online tool to contemplate calculate your potential insurance cost in 2014. by clicking on shop and compare the site will take you to another page where you can input your family and income information to break down the monthly costs and possible tax credits. coming up we'll show you what the average bay family will pay each month. they're young and they think they're invincible and they're often uninsured. >> getting people signed up is a big challenge. >> not just any people. young people. coming up while the success of obama care could hinge on this group. we're back in two minutes. [ laughter ]
getting health insurance on your own is not going to be cheap or easy but the aim of affordable care act is toic mate more accessible to everyone. here's the tool on the covered california site to help you shop and compare. first we put in the number of people in your house hold. let's say this is a family of four. we'll type in four here. and house hold income. the average in the bay area is about $70,000. and then the zip code. let's say this family is from santa clara county. now we type in the enroll lee information, the age of each adult. how about 40 and 42. and then the number of dependents age 18 and under. this family has two kids so we type in two there, total people covered, four and then we see the options. the next page that comes up, it's like a preview page, an overview preview page with total of four options including your best two options.
you do have to close out this page and see details of your options. so we're going to take a lock at that. see that you have two plans that are available that are best for you, the bronze 60 plan and your premium can be as low as $279. but if you view the details of this plan, the deductible is pretty high at $5,000. now let's take a look at the other plan that they recommend. the enhanced silver plan, your total monthly payment, a bit more within $539. but if you view the benefits and details you can see the deductible is much lower at $2,000. your copays to your primary care physician and urgent care are also lower. so this could be a better option for your family if you expect your family needs to see the doctor more often. so in the end, less out of pocket. >> okay. go explanation. interesting to see how it all works. to keep the costs relatively affordable one key group needs to enroll, that group is young
people. >> if they don't come out and sign up for the coverage, it could undermined the success of the law. >> it's the generation called the young invincibles, 19 to 35, healthy, a spring in their step and confident. what if good health isn't just a layup. we asked the uninsured in this group of 20 or 30-somethings if they plan on signing up for obama care. >> i'll play it by ear. i think the safest route, because vi a family of five, it's like you got to play the card as it comes. >> and you think most people will sign up? >> i think so. if it makes economic sense i think there's a good chance of them doing that. >> there's no question that the administration is hoping that the optimism expressed on this court will play out in cities across the country because if young people don't sign up and choose to pay a fee, make no mistake, it could create a problem. >> if the risk pool ends up
being those that are sicker or older, then we're going to see significant rate increases. getting people signed sup a big challenge one one we're going to successfully undertake. >> if young people don't sign up in large numbers, we're look at a risk poll pool of older folks that exhaust a lot of resources. if there's only a small group of healthy people to counter balance the cost it won't work. that pool would be more economically viable. it's not just the commissioner of california issuing the warning. kfrd california and the insurance groups selling on the exchange kprez this as well. >> if we have only those who are preexisting conditions or those who are older signing up, it will cause increasing preyums in
into an easy dinner with crescent dogs. just separate, add hot dogs, cheese, roll 'em up, and bake. lookin' hot, c-dog. pillsbury crescents. make dinner pop. but press them flat, add sauce... and some pepperoni and cheese... and school nights turn into grands mini pizza nights. pillsbury grands biscuits. make dinner pop! and school nights turn into grands mini pizza nights. to thoseworried...ited... poked and prodded... taken risks... and lived in a state of "what if?"... welcome to a new state... of health. welcome to covered california. the place to find quality, affordable coverage. financial help for those in need. and nobody can be denied because of a pre-existing condition. enroll now at coveredca.com.
the question we hear the most is around preexisting conditions. people who have had a preexisting kb don't actually know that they're going to get coverage through covered california. welcome back. thousands 0 people have questions. we're here to try to answer some of them. anthony wright from health access is here too help us. his organization advocates quality health tear for all californians. so you heard that. preexisting conditions is really on people's mind. under the new health care law
that's one thing that can't be considered when buying health insurance, correct? >> absolutely. in the previous world people had a long application they had to fill out. that's all gone. you cannot be denied for your preexisting conditions. you have to apply during the open enrollment period but beyond that there is no other requirement. you also can't bet charged differently based on your health status which is very important for affordability. >> people have ahuge affinity for the doctor they've been seeing. under this can you choose to stay with your own doctor or do you have to shop for another doctor? >> you can keep your own doctor. the covered california website has an impress i tool where you can type in the name of your doctor and see what plans have your doctor in the network or your local hospital. most hospitals are in at least one to have plans so you may have to make a decision about whether you want to go for a lower premium or for a plan with a bigger network or with
providers you want. but you can make that choice as you're going through the options on the website or 0 on the phone with the call center. >> one of the things we hear people talk about the most is the issue of the fine, if you don't have insurance by a certain date there will be a fine for people who don't sign up. tell us a little more about how that fine is going to work. it's minimal but then it increases. >> it starts at $95 a year. it grows to about 2 .5% of income. but frankly most people want to be covered. they want the peace of mind of having coverage so they don't have to live sicker, die younger, be one emergency away from financial ruin. but if the options that are available are not affordable, it is a viable option just to say i'll pay on my taxes at year-end that additional assessment. but the problem is that you don't get covered as a result and you have to wait -- if you do get sick you have to wait until the next open enrollment
period to sign up. you have to sign up during the open enrollment periods. >> the fine for the children is half of what it is for an adult, correct in. >> that's correct. >> one of things people are confused about is in terms of small businesses with less than 50 employees, are they required by the law? they're not required to sign up but there is access on the website if they choose? isn't there a shop area? >> part of the new covered california exchange that is for small businesses to sign up for coverage. some of the businesses can get tax credits so they can better afford to cover their workers but there is no requirement on employees. there is an assessment on large employers if they don't provide coverage and their workers go to covered california and get subsidies that they have to help covered that. most employers who do provide coverage will continue to do it because that's how they attract and retain the workers. we want to make sure we have a safety net so that all of those
workers who don't get coverage now have a place to go to get affordable quality coverage. >> what's the biggest misinformation that you think is out there about covered california? >> i think that people think it's a more radical change than it is. this is the private coverage that people expect and are used to now. you can't be denied for a preexisting condition yb you can get financial help to afford it and it's a much easier way to do it. health insurance is not cheap and easy but this will make it cheaper and easier. >> thank you very much. okay. coming up, sure you have to pay for your insurance but you do get many free benefits. coming up on our special, we outline what preventive care you get when you enroll. [ laughter ]
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zploo as you see, obama care isn't necessarily cheap but its aim is to be aforable. >> marianne favro shows us what's include. >> in an effort to keep more people out here, the affordable care act is requiring insurance plans to cover preventive services so people can be treated earlier and not need costly treatments. >> they're going to have access to screening tests, in particular for certain cancers, diabetes, high blood pressure, depression. >> 15 preventive services for
adults will be covered under the affordable care act everything for diet counseling to your seasonal flu shot and nine other imnigh zagss. women will have their annual exams covered. >> every single plan covers mental health and substance use, disorder services and covers it at the same level as treatment for other illnesses and these what's probably the biggest thing about obama care in this area. >> for most it's a welcome change. >> important. just as important as your physical health. >> i think it's wonderful. it's so needed for a long time. >> some doctors admit that initially patients may experience a longer wait for some screenings because the ininsured may flood the offices to get the tests they've put off for years. but after the first year the health care market should adjust to accommodate extra patients.
this psychiatric professor says now people who need health services will finally g able to get the early help and that will save lives. >> to have this level of coverage and not have to worry about going bankrupt and be able to get access to high quality care, that's life saving. >> to give you an idea the impact the affordable care act will have son this hospital, valley medical center is expecting to see 5,000 new patients next year who will be enrolled in the valley care plan offered through covered california. >> now this next part is very important. do you know the difference between covered california and california covered? one is the near insurance marketplace. >> the other is a fraud that you need to be aware of. >> once again her's sam brock. >> at first glance california covered looks a lot like what it purports to be, a health insurance benefits exchange and
insurance comparison. scroll down on the now defunction site and you'll see options for free quotes and the promise that covered california begins in january of 2014, which it does. but california covered is a scam, according to the state. covered california is real. and the two sound so alike even the state's insurance commissioner can get a little tongue-tied. >> california covered, which is a website that appears to be designed to try to attract people to it pretending to be covered california. even i'm having a hard time because it's so close in terminology. >> commissioner jones says the insurance department investigators unroflded the following front. california covered was getting protection from a server based company in texas and being orchestrated by an unlicensed broker in panama, some 4,000 miles away. >> we were successful in contacting the texas owner of the site, if you will, that was
allowing the ultimate owners to deploy this information across their server, across their web portal and we got them to shut it down. >> the department of insurance will continue to look out for californians and investigate questionable sites. but for the several million people who might buy insurance through the state health care exchange other potential traps lurk too. some license agents have applied to change their names and presentations he said possibly to look like covered california. so far they've rejected 193 requests like this one, covered insurance group or even closer, california insurance exchange. while you can buy california covered products through licensed dealers or brokers, jones says consumers should know there is a distinction. >> there is something different about being in the agent and broker space and being covered
california which is a governmental entity. so we think consumers should understand those differences and not be misled into thinking one is the other or the other is the one. >> that was sam brock reporting. there's a lot of information to review. we invite you to go to our websi website. when you go to the home page you can see covered california in a pot light section. when you click on the icon it will take you to the entire guide. >> we hope you found the covered california special informative and useful. >> thanks for watching. hope to see you back on monday. >> have a good evening. woah, this kitchen is beautiful!
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♪ i finally found the right snack ♪ woah, this kitchen is beautiful! give him the tour. let me show you! soft-close drawers, farm sink! where's my room? we had to take just a little bit for the kitchen. because your kitchen dreams can be big. ikea has it all. >> miley mad needs continues. valerie ends herbal room run and welcome to "access hollywood". the big news is the kris and bruce jenner split after 22 years of marriage kris make big announcement but big
surprise. they have been separated for a year. >> it's a shame that, you know, sf stuff is completely fabricated. that's definitely completely fabricate ichld. >> we are fought getting divorced. not in a million gazillion years. >> if anybody is intelligent to look at how silly it is if. >> tonight split time and time again over the last year turns out kris is hiding the truth that she and bruce were separated during all those months with headline of us weekly screaming it's over kris telled the the magazine we are living apart but there's no animosity. we are quantityed and committed to our family. i will always love him but no longer a couple in that way. married in 1991 dated for seven seven months there was a theme for awe'll now and billy found out from bruce last summer at the